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Am J Kidney Dis. 2010 Oct;56(4):774-9. doi: 10.1053/j.ajkd.2010.04.020. Epub 2010 Aug 14.

Treating profound hyponatremia: a strategy for controlled correction.

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  • 1Rochester General Hospital, Nephrology Division, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA.


An alcoholic patient presented with profound hyponatremia (serum sodium concentration, 96 mEq/L) caused by the combined effects of a thiazide diuretic, serotonin reuptake inhibitor, beer potomania, and hypovolemia. A computed tomographic scan of the brain was indistinguishable from one obtained 3 weeks earlier when he was normonatremic. Concurrent administration of 3% saline solution and desmopressin controlled the rate of correction to an average of 6 mEq/L daily and resulted in full neurologic recovery without evidence of osmotic demyelination. This case illustrates the value of controlled correction of profound hyponatremia.

Copyright © 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

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